The critical period for development of secondary restenosis following post-intubation tracheal stenosis surgery

Abstract

Background

Determining a predictable duration to restenosis very essential for reducing mortality and morbidity for tracheal stenosis surgery.

Objectives

The aim of this study was to determine the critical periods for secondary restenosis risk for operated patients with post-intubation tracheal stenosis (PITS) during the initial healing period.

Methods

A total of 61 patients with a diagnosis of surgically treated PITS were included in the study. Treatment groups were carbon dioxide (CO₂) laser and tracheal resection with primary anastomosis (TRPA). Duration to restenosis was compared with Kaplan–Meier curves between study groups.

Results

Restenosis developed in 11 (18.0%) patients and was diagnosed after a mean of 39.3 ± 38.5 (range, 22 to 155) days. Gender or Cotton–Myer grade of the PITS was not found to be risk factors for the development of stenosis. Restenosis rate was 33.3% in CO₂ laser group and 10% in the TRPA group (p = .036). Duration to restenosis was detected at a median of 28 days in patients treated with CO₂ laser, and a median of 30 days in patients treated with TRPA (p = .024).

Conclusions

The most critical period for the development of restenosis after PITS treatment is the third and fourth weeks, especially in patients treated with CO₂ laser.

Chinese Abstract

背景：确定可预测的再狭窄持续时间, 它对于通过气管狭窄手术降低死亡率和发病率非常重要。

目的：本研究的目的是确定 插管后气管狭窄 (PITS) 的手术患者在初始愈合期间发生 继发性再狭窄风险的关键时期。

方法：本研究共纳入 61 名经手术治疗 PITS 的患者。治疗组是二氧化碳 (CO₂) 激光和气管切除伴一期吻合术(TRPA)。进行研究组之间的再狭窄持续时间与的 Kaplan-Meier 曲线的比较。

结果：11 名 (18.0%) 患者出现再狭窄, 在平均 39.3 ± 38.5天（范围为22 到 155天）后得到诊断。未发现性别或 PITS的Cotton-Myer 等级是发生狭窄的危险因素。 CO₂激光组再狭窄率为33.3%, TRPA组为10%（p = .036）。在接受CO2 激光治疗的患者中检测到再狭窄持续时间的中位数为 28 天, 接受 TRPA 治疗的患者中位数为 30 天 (p =.024)。

结论：PITS 治疗后发生再狭窄的最关键时期是第三和第四周, 接受 CO₂ 激光治疗的患者尤为如此。

Keywords:

• Tracheal stenosis
• Cotton–Myer grade
• restenosis
• tracheal resection
• CO₂ laser

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Data will be shared if requested.